Wisdom Tooth Removal

After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post-operative care is of critical to success of the procedure. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully. If a temperature greater than 101 persists, notify our office.

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for one hour. After this time, the gauze pad should be removed and discarded.
• Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
• Take the prescribed pain medications as soon as you begin to feel discomfort or as directed by your surgeon. This will usually coincide with the local anesthetic beginning to subside.
• Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
• Place ice packs or bags of frozen peas to the sides of your face where surgery was performed. Refer to the section on swelling for explanation. Do not leave the ice or peas in place longer than 20 minutes at a time.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is common. Excessive bleeding may be controlled by first rinsing your mouth with cold water, then placing a fresh gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding persists, bite on a moistened tea bag over the surgical site and apply firm biting pressure for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting any bleeding vessels. To minimize further bleeding, limit physical activity, keep your head elevated, and avoid exercise. If bleeding does not subside, call the office for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be applied continuously while you are awake. After 36 hours, ice has no beneficial effect. Swelling or jaw stiffness may persist for several days and is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face and surgical site is beneficial in reducing swelling.

Pain

The pain medication prescribed by your surgeon should be taken when you feel the local anesthesia effects beginning to wear off. Take the medications prescribed as directed and not on an empty stomach. The prescription pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should begin to subside more and more each day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthesia or I.V. sedation, liquids should be consumed first. Do not use straws. Drink from a glass. The sucking motion may cause more bleeding by dislodging the blood clot. You may progress to eating soft foods but use caution and chew away from the surgical sites. High calorie, high protein intake is very important to your recovery following surgery. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 6-8 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Please avoid nuts, seeds, popcorn, and chips for 2 weeks.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the Mouth Clean

No rinsing of any kind should be performed until the day following surgery. Resume brushing your teeth the next day following surgery. Begin rinsing with warm, salty water the day following surgery to assist with cleansing of the surgical areas.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been prescribed antibiotics, take the tablets or liquid as directed until the course is completed. Antibiotics may be given to treat or help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reactions that you experience and call our office for further instructions. It is important to discern side-effects versus true allergies.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including any prescribed medicine. You should then sip on coke, tea, or ginger ale. When the nausea subsides, you may begin introducing solid foods as well resuming any prescribed medication

Other Complications

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As discussed before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation so additional care must be taken while eating. Call our office if you have any questions.
• Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the discomfort that accompanies a fever.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not remnants of the tooth roots but are the bony walls which previously supported the tooth that has been removed. These projections usually smooth out spontaneously. If not and issues persist, call the office for further instructions.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
• A sore throat and pain when swallowing is common following surgery. This will subside in 2-3 days.
• Stiffness (Trismus) of the jaw muscles may cause difficulty or limitation in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Finally

Sutures are placed in the area of surgery to minimize post-operative bleeding and to aid healing. The sutures will usually dissolve approximately one week after surgery. If removal of sutures is required, it only takes a minute or so, and there is no discomfort associated with this procedure.

The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call our office for instructions.

Your case is individual, no two mouths are alike. Do not accept well intended advice from friends or internet blogs. Discuss your problem with the people best able to help you – the surgeons and trained staff at SouthOMS who are most familiar with your case.

Brushing your teeth is okay starting the following day – just be gentle at the surgical sites.

A dry socket occurs when the blood clot gets dislodged or lyses prematurely from the tooth socket. Symptoms of pain not relieved with pain medications at the surgical site and radiating to the ear and surrounding teeth may occur 4-5 days following surgery and may be indicative of a dry socket. Call our office for further instructions if this occurs.

Our doctors are always available. Outside of normal business hours, please call our office for specific contact instructions to reach the doctor on-call with any questions or concerns.